142 PEINCIPLES OF TETEEINAKT SUEGERT 



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Classify hernias according to the contents of the sac. 

 Eaterocele contains intestines only. 

 Epilocele contains omentum only. 

 Entero-epilocele contains both, of the above. 

 Cystocele contains the bladder. 

 Gastrocele contains the stomach, etc. 



Name the clinical varieties of hernia. 



1. Reducible. The contents of the sac can readily be 

 returned into the abdominal cavity. ' 



2. Irreducible. The contents cannot be returned, due to' 

 incarceration or inflammatory adhesions. 



3. Incarcerated. The contents of the bowel form an 

 obstruction to the return of the bowel into the abdomen. 



4. Strangulated. An arrest of the circulation of the pro- 

 truded bowel, due to severe constriction at its neck. 



How are hernias classified as to their origin ? 



(1) Congenital ; (3) acquired or traumatib. 

 Crive the symptoms of a reducible hernia. 



In the so-called hernial region (region of the umbilicus, 

 inguinal canal) a swelling is found, which is soft, regular, 

 round and smooth. As a rule, there are no symptoms of 

 inflammation, as heat, pain, swelling of the adjacent tissues. 

 The integument over the tumor can be displaced. The con- 

 tents , of the sac either slip from under the palpating fingers 

 or have a doughy, uneven feel. In the former it contains 

 bowels only; in the latter, omentum. Of course both may be 

 present together. On placing the finger against the tumor 

 and pushing it toward the wall of the cavity from which 

 the tumor comes, the rent in the wall or the dilated state of 

 the natural canal through which it came (inguinal canal)— 

 that is, the mouth of the hernia — can be felt. This varies ia 



